A comparative study of cytological processing techniques in hemorrhagic effusion

OBJECTIVES: Fluids are one the most common specimens received in cytology laboratories. The presence of erythrocytes may obscure the cells in the smears, making the diagnosis, and identification of cells difficult. Many techniques are being used by laboratories to eliminate these erythrocytes. The present study was undertaken to improve the quality of cytology smears of hemorrhagic samples by comparing three different techniques, namely, Carnoy’s fixative (CF), modified CF, and normal saline rehydration technique (NSRT) to hemolysis red blood cells (RBC) present in the smear background for better cytological assessment. The present study was a prospective study done over 1 year 6 months from November 2012 to March 2014, in the Department of Pathology in a Tertiary Care Rural Medical College. MATERIALS AND METHODS: All hemorrhagic effusions received in the department of pathology were processed using CF, modified CF, and NSRT. The background of the smear and cytomorphological details with two different stains was analyzed. The Chi-square test was used to find out the association of different techniques in the reduction of RBC. RESULTS: More than 60% reduction of RBCs in the smear was noted in 85.40%, 14.60%, and 15.60% by NSRT, modified CF, and CF, respectively. Staining was better and nuclear features were best preserved in NSRT. CONCLUSION: NSRT is the best, simple, and cheaper technique to lyse RBC in the hemorrhagic fluid. It also shows better staining and well-preserved cytomorphological features of the cell.